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'""� <br /> c <br /> � <br /> APPLICATI� FOR CONSTRUCT►.�lN PERMIT ��"P« � <br /> � e' �q E g o� TO BE COMPLETED IN INK—PLEASE PRINT <br /> cirv o� <br /> eve rett r HEATING SYSTEM: �3AS C,�ELECTRIC ❑_ <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> '� (� DEMOL{iION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> • n OVMER MMLAp�RESS CIiV ZIP P�ONE b�4C <br /> a � , p1+.tPa, �a�u��s��� 4`1�bAtx� 1J 2Jr'R�lt 94sL°3 '�S-a3T7 _ � <br /> TENANT M�R�DONE55 CIiY 2iP GHONE <br /> �RCNILEGt �ESIGNER M�R�DORF�S C�TV 21P FM�ME <br /> ��� Pr�.vt �� Izti�� t��n.�r w '�o� c�� 9P�u�F 34�- c�144- _ <br /> ��O GENERMGONtRAGTOR MAILAOORE55 CItV 2iP PHONE LiCEN5E1 — <br /> � � 1.. ..rnoi �. /r �=,}��TiorJ 4q�8 D.t.ti� ��. l-�k�-ET -r'1f5?A3 7kS331� 1-11l,qEL o91�CZ <br /> �� MECHANICAICONTR�CiOR 1AML�DORE55 GIT`/ Z�V P110NE IICENSE/ — <br /> �^ PWMBiNOCOqtN�GtOR M41L��URE55 CIiY ZiP PMONE UCENSE� <br /> �W <br /> p1.1• cussaw«+K . <br /> y_r�„� �� � NEW PODITION � ALTERATION REPAIR DEMOLITION . WOODSTOVE/FRPL INSERT ' � BUILDIN6 RELQCATION <br /> yf] � CCWT�CT PER50 �NO PNONE NO <br /> t � L--- � 3 3 �7 <br /> CONTMLTVRIClOFWON� �' DUO <br /> � OESCRiBE V10f1N�N�50U�PE f�OUGE INVOIV �� <br /> rr A�sEouseo�euaor I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> �� APPLICATION AND HNOW?HE SAME TO BE TPUE AND CORRECT.ALL <br /> IEO�lDE5LR1VTqNOFPPOPERTY15�qWNBELOWOR�iUGHiWRCOPIE51 PROVIS�ONSOFLAWSANDOHDINANCESGOVERNINOTHISTVPEOF <br /> WORH WILL BE COMPLETED WITH WHETIIER Sf FCIFIED HEREIN OR <br /> �or eiceK or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OIVE ' <br /> AUiHORITV TO VIOLATE OR C0.NCEL TyE PROVISIONS OF ANV <br /> ��012E �G�2Q� ��1� OTHER STATE OR LOCAL LAW REOULATIPIC CUNSTRUCTION OR THE � <br /> PERFOHMAM7E OF CONS?PUCTION.THAT I AM AUTHOPI2ED BY THE <br /> �t'� �O3 ' CJ—O) OWNER OF IHIS PROPERiV TO PERFORM THE WORK FOR WHICM <br /> A APPLICATION IS MADE ANU I COMPLV WITH THE STATE <br /> 1 �N �UT� Iy y� F� O� LlJQj�jr' ��� WL �JCONTRE«O�tnnGTOROFAJtNORIZEUDGENT2OO'WAE. <br /> �,D �ooLOT _L-��S S tl ���'�.�/�`+ry��-J��— I-1��E�U Con��'. <br /> /, ' APPLIL�NTSC�TVBUSM[SSIIGCN5EN0�NDtlU5ME5SNAME <br /> K <br /> PLUMBING MECHANICAL <br /> ���1,� N0. TVPE OF FI%TURE OR ITEM FEE NO. TYPE OP EOUIPMENT PEE <br /> � � � WA7ER CLOSET(TOILET) �- NC—NHNDLG UNITS—H,P. i <br /> r� 1 FORCED AIR S`'STEMS—A LU. M E.A. <br /> � enrHr�ia S I- �-- <br /> LAVATORV(WASH BASIN) S �— UNIT HEATEFS—B.T.U. M <br /> SHOWEIi S" CLOTHES DRVERS <br /> C� _ KITCNEN SINK 6 DISP VENiILATION FAN <br /> � DISHWASHER RANGE HOOD —� <br /> � LAUNDRVTRAY WATERHEATER <br /> CI.OTHES WASHER WOOD STOVE <br /> �, �_p� URINAL METAL FIREPLACE 8 CHIMNEY <br /> � DRINKING FOUNiA�N FIREPLACE INSERT <br /> FIOOR DRAIN HEAT PUMP <br /> � BACKFLOW PHEVENTERS GAS PIPING <br /> I ROOF DRAINS—flAINLEADERS E%HAUST FAN <br /> I �� SINK(SERVICE—BAR.ETC.) <br /> + �1� <br /> � SUBTOTAL f U I '� SUB'OTAI $ 3 — <br /> ' PERMIT E PEFMIT f <br /> TOTAL FEE S sLJ ' — TOTAL FEE E �O ' — <br /> �� FOR OFFICE USE ONLY: � � 3`� �� <br /> - FRp1i5ETB�CN RE�NSEtBACK S�OE���C; PUN%NF.ICNUY%C� fE�L�r I� RE EiPiNO <br /> Z ' 2 ' S 9 7 <br /> use zor�e iot eaee �ec�Nr srte FEES VALUATION FEE <br /> R�S n BUIIDING <br /> rvv�oicoxisuioweeu rrr�orcoxsi�cmni «a�.�� +oa����F����s �Z�510 3ln � OT� <br /> �.°°°' ( PwuaiHn ac� I - <br /> �-L__ "N — — <br /> S�2E OF BLIX3 NO OF SiORiES BASEMENL MECHANICAL ,�i � <br /> 894 S.F. no�� Z YE p�DIT10NALPUNCHECN <br /> OGCUV�NCVLOAD FlHESPRNNlERSAEQD NC.IGMUMI1RiIlN� ��a � �� <br /> /✓J �Q1 <br /> `� OTHf.P ' <br /> REASONiORSFNINNlERS �I � <br /> STATE BURDING SURCHARGE �_ <br /> INi�nE AV PLANS�PPROVF.OBv CITY OF EVERETT PUBLIC WORKS — <br /> LOCALSALES <br /> (1.?J' 7� TAX CODE IS 3105 TOT�� 3(F, '/ <br />